Phone: 801-423-1334 ~ E-mail: LostPawsInc@gmail.com ~ Hours: 9-5pm Mon-Fri (when able)

(Please read the Adoption Process here first)

LOST PAWS, Inc.

PET ADOPTION APPLICATION FORM

THIS FORM MAY TAKE APROX. 15 - 20 MINUTES TO COMPLETE

One of the most frustrating aspects of adopting from a qualified rescue group is the time it takes. This attention to detail is one of the reasons why our placement success ratio is somewhere around 99% overall. We are all volunteers. The members of our organization work outside the home, and they each have their own families and their own animals to attend to in addition to the volunteer work they do for us. If you are not willing to be patient during the adoption process, then adopting from our rescue may not be your best option. Be sure to read the dog’s bio to ensure that you can offer what that dog needs. Please be aware that all of our available dogs have people currently trying to qualify to adopt them. Our goal is to find the best home for each individual dog, not the best dog for each individual home. If you understand these basic guidelines, and you are willing to abide by them, please complete the adoption application below.

Potential Adopter Information:

Full Name:
Address:

City:
State:
Zipcode:
Phone:
E-mail:
Birthdate:	(dd/mm/yyyy)

How did you hear about LOST PAWS, Inc.?
Web Site/Search
Petfinder
KSL
Petsmart
Friend or Family
Other:

Animal:

Type of Animal: Dog Cat

First choice:	(Name)
Second choice:	(Name)

Housing:

Type of home: Own Rent
If you rent, do you have permission from your landlord? No Yes
Where will the pet be kept? Indoors Outdoors
Will the pet be left at home alone? No Yes If Yes, how many hours per day?
Will the pet be kept outdoors? No Yes
Is there a secure, fenced area? No Yes
Type of Fence: Height of Fence:

Family:

Who is this pet for?
Are there children living in the home? No Yes Ages:
Do any family members have allergies to pets? No Yes
Tell us why you would like to adopt this animal:

Pet History:

Have you relinquished a pet to a shelter before? No Yes
If Yes, why?

List all pets currently at your home:
1) Breed: Age: Spayed/Neutered?
2) Breed: Age: Spayed/Neutered?
3) Breed: Age: Spayed/Neutered?

Micro-chip:

If we have your pet micro-chipped today for $20, your pet’s microchip information will be registered with 24PetWatch pet recovery database.
Yes, I consent to the release of my name and telephone number to anyone that finds my pet.
No, I prefer that communication only be through 24PetWatch.

Limit of Liability:

You must understand and agree with all of the following statements to apply for adopting a pet from LOST PAWS, Inc.:

LOST PAWS, Inc. will not be liable for medical expense incurred by said pet after adoption. Do you agree to this?
No Yes

There is always a risk when getting a new pet that we don’t have a full history on. It could get sick with distemper for cats/kittens or parvo for dogs/puppies. There is no way that we can guarantee they will not get it after they are adopted. Do you understand that LOST PAWS, Inc. is not liable for medical bills if the said animal gets sick from these diseases?
No Yes

Do you understand that if for any reason this pet needs to be returned it will be given back to LOST PAWS, Inc.?
No Yes

Financial and Physical: By checking this box, I am stating that I am financially and physically able to care for this pet. I understand that proper food and veterinary care can be costly and I am able to meet these requirements.

Truthfulness: By checking this box, I understand that if the information contained herein is found to be false, my application can be refused or said pet adopted shall be relinquished to LOST PAWS, Inc. without a refund of monies paid.

Adoption Fee Statement: I agree that by checking this box, I understand that the Adoption Fee is a donation and is non-refundable or exchangeable.

LOST PAWS, Inc. reserves the right to deny an application for any reason.

Additional comments, if any:

Please enter your initials to digitally sign this document:

-- END OF ADOPTION APPLICATION FORM --

Forms

- Adopt a Pet - Surrender a Dog - Surrender a Cat

LOST PAWS, Inc.

PET ADOPTION APPLICATION FORM

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